Salmonella enterica
is one of the most important foodborne pathogens around the world. In the last years,
S
.
enterica
serovar Infantis has become an important emerging pathogen in many countries, often as multidrug resistant clones. To understand the importance of
S. enterica
in the broiler industry in Ecuador, we performed a study based on phenotypic and WGS data of isolates from poultry farms, chicken carcasses and humans. We showed a high prevalence of
S. enterica
in poultry farms (41.4%) and chicken carcasses (55.5%), but a low prevalence (1.98%) in human samples.
S
. Infantis was shown to be the most prevalent serovar with a 98.2, 97.8, and 50% in farms, foods, and humans, respectively, presenting multidrug resistant patterns. All sequenced
S
. Infantis isolates belonged to ST32. For the first time, a pESI-related megaplasmid was identified in Ecuadorian samples. This plasmid contains genes of antimicrobial resistance, virulence factors, and environmental stress tolerance. Genomic analysis showed a low divergence of
S
. Infantis strains in the three analyzed components. The results from this study provide important information about genetic elements that may help understand the molecular epidemiology of
S
. Infantis in Ecuador.
Didactic knowledge about contents is constructed through an idiosyncratic synthesis between knowledge about the subject area, students’ general pedagogical knowledge and the teacher’s biography. This study aimed to understand the construction process and the sources of Pedagogical Content Knowledge, as well as to analyze its manifestations and variations in interactive teaching by teachers whom the students considered competent. Data collection involved teachers from an undergraduate nursing program in the South of Brazil, through non-participant observation and semistructured interviews. Data analysis was submitted to the constant comparison method. The results disclose the need for initial education to cover pedagogical aspects for nurses; to assume permanent education as fundamental in view of the complexity of contents and teaching; to use mentoring/monitoring and the value learning with experienced teachers with a view to the development of quality teaching.
Objective
There are limited published data about the circulation of influenza B/Victoria and B/Yamagata in Latin America and the Caribbean (LAC) and most countries have a vaccine policy that includes the use of the trivalent influenza vaccine. We analyzed influenza surveillance data to inform decision-making in LAC about prevention strategies, such as the use of the quadrivalent influenza vaccine.
Methods
There are a total of 28 reference laboratories and National Influenza Centers in LAC that conduct influenza virologic surveillance according to global standards, and on a weekly basis upload their surveillance data to the open-access World Health Organization (WHO) platform FluNet. These data include the number of specimens tested for influenza and the number of specimens positive for influenza by type, subtype and lineage, all by the epidemiologic week of specimen collection. We invited these laboratories to provide additional epidemiologic data about the hospitalized influenza B cases. We conducted descriptive analyses of patterns of influenza circulation and characteristics of hospitalized cases. We compared the predominant B lineage each season to the lineage in the vaccine applied, to determine vaccine mismatch. A Chi-square and Wilcoxan statistic were used to assess the statistical significance of differences in proportions and medians at the
P
<0.05 level.
Findings
During 2010–2017, the annual number of influenza B cases in LAC was ~4500 to 7000 cases. Since 2011, among the LAC-laboratories reporting influenza B lineage using molecular methods, both B/Victoria and B/Yamagata were detected annually. Among the hospitalized influenza B cases, there were statistically significant differences observed between B/Victoria and B/Yamagata cases when comparing age and the proportion with underlying co-morbid conditions and with history of oseltamivir treatment (
P
<0.001). The proportion deceased among B/Victoria and B/Yamagata hospitalized cases did not differ significantly. When comparing the predominant influenza B lineage detected, as part of surveillance activities during 63 seasons among 19 countries, to the lineage of the influenza B virus included in the trivalent influenza vaccine used during that season, there was a vaccine mismatch noted during 32% of the seasons analyzed.
Conclusions
Influenza B is important in LAC with both B/Victoria and B/Yamagata circulating annually in all sub regions. During approximately one-third of the seasons, an influenza B vaccine mismatch was identified. Further analyses are needed to better characterize the medical and economic burden of each influenza B lineage, to examine the potential cross-protection of one vaccine lineage against the other circulating virus lineage, and to determine the potential impact and cost-effectiveness of using the quadrivalent vaccine rather than the trivalent influenza vaccine.
OBJECTIVE: to identify competency strengths and weaknesses as perceived by nursing
professionals who graduated with a integrated curriculum and competency-based
through Problem Based Learning in small groups. METHOD: an intrinsic case study method was used, which analyzes this innovation through
former students (from the first class) with three years of professional
experience. The data were collected through a questionnaire and discussion groups.
RESULTS: the results show that their competency level is valued in a very satisfactory
manner. This level paradoxically contrasts with the lack of theoretical knowledge
they perceived at the end of their education, when they started working in
clinical practice. CONCLUSIONS: the teaching strategy was key to motivate an in-depth study and arouse the desire
to know. In addition, Problem Based Learning favors and reinforces the decision to
learn, which is that necessary in the course of professional life.
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